Incidence Of Fetal Abnormalities Research Articles

Systematic review and meta-analysis of the association between young maternal age and fetal abnormalities

Fetal anomalies among young women and adolescents pose major public health concerns. This systematic review aims to elucidate the relationship between young maternal age and the incidence of fetal abnormalities. According to the systematic review and meta-analysis PRISMA protocol, cohort, cross-sectional and case–control studies were scrutinized to include 80,393,450 participants across diverse regions. The meta-analysis utilized Odds Ratios (OR) as the effect measure, adopting a random-effects model. The screening process involved 157 selected and verified manuscripts, which ultimately resulted in the final inclusion of 20 studied in the meta-analysis. The criterion for young maternal age was the age of ≤ 20 years. The meta-analysis revealed a pooled OR of 0.93 (95% CI: 0.82–1.05, p = 0.252), indicating no statistically significant association between young maternal age (≤ 20 years) and fetal anomalies. However, considerable heterogeneity (I² = 96.21%) was noted, prompting the use of a random-effects model to derive the reported results. The meta-analysis did not find statistically significant differences in the occurrence of congenital anomalies in fetuses of younger women than in overall population. Although due to significant heterogeneity of the analyzed studies, and a risk of bias, caution should be exercised when interpreting the results, further investigation may be warranted to understand the relationship between maternal age and risk of fetal anomalies. Nevertheless, the study shows significant differences, which diminish in collective analysis, suggests that factors beyond age may be influential. Specifically, the limited access to or quality of healthcare in certain regions could be a more critical factor than maternal age itself.

PREVALENCE OF GESTATIONAL DIABETES AND RELATED COMPLICATIONS IN DISTRICT SIALKOT

Gestational diabetes mellitus (GDM) is a prevalent medical complication during pregnancy, associated with adverse maternal and neonatal outcomes. Understanding the impact of GDM on pregnancy complications is essential for effective management and care. Objective: This study aimed to compare the incidence of various complications between pregnant women with and without GDM. Method: A total of 200 pregnant women were recruited from Govt. Sardar Begum Teaching Hospital Sialkot and Civil Hospital Sialkot. These patients were given 75 g oral glucose irrespective of the meals, and their plasma glucose was estimated at two h. Patients with plasma glucose values of 140 mg/dl were labelled GDM; the rest were the control or non-GDM groups. All GDM patients were followed up and treated with diet and insulin therapy till delivery to know maternal and fetal outcomes. Results: Among the enrolled pregnant women, 70 (35%) were diagnosed with GDM. Significant differences were observed between the Non-GDM and GDM groups in terms of Cesarean section delivery (23.8% vs 55.7%, P=0.001), hypertension (13.8% vs 74.3%, P=0.031), and preterm birth (17.7% vs 24.3%, P=0.001). However, no significant difference was found in the incidence of fetal abnormalities between the two groups (9.2% vs. 8.6%, P=0.012). Additionally, the risk of intrauterine fetal demise was comparable between the Non-GDM and GDM groups (10.0% vs. 11.4%, P=0.031). Conclusion: Pregnant women with GDM are at increased risk of Cesarean section delivery, hypertension, and preterm birth compared to those without GDM. However, the incidence of fetal abnormalities and intrauterine fetal demise does not significantly differ between the two groups. Early detection and management of GDM are crucial to minimise adverse pregnancy outcomes.

The Relationship between Screening Markers in the First Trimester of Pregnancy and Chromosome Aberrations

Background:This study was designed and performed to investigate the relationship between fetal chromosome aberrations and screening markers in the first trimester of pregnancy in order to prevent the birth of infants with chromosome aberrations with early prenatal diagnosis.Methods:We conducted an analytic cross-sectional study on result of chromosomal culture of 762 pregnant women with high-risk combined screening test from December 2018 to June 2020 and analyzed by SPSS program.Results:There was a significant relationship between chromosome structural abnormalities with free beta-human chorionic gonadotropin (free β-hCG) values equal to and higher than 1.5 multiples of the median (MoM) (P: 0.05). The highest incidence of disorder in number of chromosomes with abnormal nuchal translucency (NT) percentiles (≥99%) was seen (P < 0.001). It also shows that the cumulative number of chromosome aberrations of 25 (78.12%) occurred in individuals with a NT less than 99th percentile and at the same time a risk of 1/50≤ risk <1/10.Discussion:According to the results, Comparative Genomic Hybridization (CGH) array method is recommended to detect structural abnormalities in chromosomes in samples with NT ≥3.5. In addition, it is noteworthy that chromosomal structural abnormalities occur in free β-hCG ≥1.5 MoM.Conclusion:Due to the frequency of chromosomal structural disorders and its effect on the incidence of fetal abnormalities, the study of chromosomal structural disorders is recommended.

P–571 Preimplantation Genetic Testing for Aneuploidies (PGT-A) and pregnancy outcome

Abstract Study question Frozen embryo transfer (FET) of euploid blastocysts in hormone replacement therapy (HRT) or natural cycle (NC): are there differences in obstetric, fetal and neonatal outcomes? Summary answer Pregnancy complications, neonatal outcomes and fetal abnormalities are not increased after FET with PGT-A in singleton pregnancies. What is known already Since its introduction, PGT has been widely used in ART centers for preventing chromosomal and monogenic diseases. Despite its increased use, there are scarce and conflicting data about adverse pregnancy, fetal and neonatal outcomes. In one published study, the risk of preeclampsia and placenta previa was increased when PGT pregnancies were compared with non-PGT, while the incidence of gestational diabetes mellitus (GDM), preterm delivery, fetal defects and NICU (Neonatal Intensive Care Unit) admission were similar. According to other data, the rate of caesarean section in PGT pregnancies was high - around 80% in singletons. Study design, size, duration An observational, retrospective study was conducted between March 2015 and November 2019 in patients with singleton pregnancies after ART with PGT-A/FET/HRT and NC. A total number of 353 patients from two fertility centers (ART Fertility Clinics Dubai and Abu Dhabi, UAE), were included. They were divided into two groups according to the endometrial preparation for FET: group A: HRT (n = 225) and group B: NC (n = 128). Participants/materials, setting, methods Patients with primary / secondary infertility and at least one transferable euploid blastocyst after trophectoderm biopsy, achieving an ongoing singleton pregnancy after FET were included. Endometrial preparation for FET was either performed in a NC or an HRT cycle. For this study, the following pregnancy outcomes were recorded: GDM, preeclampsia and hypertension, obstetric cholestasis, placental abnormalities, mode of delivery, preterm delivery, gestational age at delivery, birth weight, fetal abnormalities and admission to NICU. Main results and the role of chance There were no statistically significant differences in maternal and demographic characteristics of the studied groups. The mean maternal age was 34.05(20–45) and 34.26(23–47) years for group A and B respectively. The mean BMI was 28.31kg/m² (17.93–43.76) versus 27.93 (17.32–43.18). The ratio of nulliparous versus multiparous patients was 1:1 for both groups. Majority of the patients in both groups were of Arab ethnicity. The number of patients recorded as smokers was low and comparable in the groups. The mean gestational age at the time of delivery was comparable: 37.64 gestational weeks (24–41) versus 37.76 (26–41). The Caesarean section rate was around 50% for both groups. The rate of preterm delivery was comparable in both groups (16.9% and 18.8% for group A and B respectively). There was no detectable difference in the distribution of the birth weight in both groups with a median weight of 3000 grams of which 13.6% were low birth weight. In the studied groups, 30.5% had pregnancy complications with no observed statistically significant differences when the groups were compared. There was no increased incidence of fetal abnormalities. Admission to NICU was comparable and was related to prematurity. Limitations, reasons for caution The limitations of the study are the retrospective design and the small number of participants. Wider implications of the findings: In patients with FET of an euploid embryo after PGT-A, the type of FET treatment preparation (HRT or NC) has no significant effect on pregnancy complications, birth weight and fetal abnormalities. The findings of the present study could be used to improve prenatal counselling for women undergoing ART with PGT-A. Trial registration number Not applicable

Value of routine ultrasound examination at 35-37 weeks' gestation in diagnosis of fetal abnormalities.

To investigate the potential value of routine ultrasound examination at 35-37 weeks' gestation in the diagnosis of previously unknown fetal abnormalities. This was a prospective study of 52 400 singleton pregnancies attending for a routine ultrasound examination at 35 + 0 to 36 + 6 weeks' gestation; all pregnancies had a previous scan at 18-24 weeks and 47 214 also had a scan at 11-13 weeks. We included pregnancies resulting in live birth or stillbirth but excluded those with known chromosomal abnormality. Abnormalities were classified according to the affected major organ system, and the type and incidence of new abnormalities were determined. In the study population, the incidence of fetal abnormality was 1.9% (995/52 400), including 674 (67.7%) that had been diagnosed previously during the first and/or second trimester, 247 (24.8%) that were detected for the first time at 35-37 weeks and 74 (7.4%) that were detected for the first time postnatally. The most common abnormalities that were diagnosed during the first and/or second trimester and that were also observed at 35-37 weeks included ventricular septal defect, talipes, unilateral renal agenesis and/or pelvic kidney, hydronephrosis, duplex kidney, unilateral multicystic kidney, congenital pulmonary airway malformation, ventriculomegaly, cleft lip and palate, polydactyly and abdominal cyst or gastroschisis. The most common abnormalities first seen at 35-37 weeks were hydronephrosis, mild ventriculomegaly, ventricular septal defect, duplex kidney, ovarian cyst and arachnoid cyst. The incidence of abnormalities first seen at 35-37 weeks was 0.5% and those that were detected exclusively for the first time at this examination were ovarian cyst, microcephaly, achondroplasia, dacryocystocele and hematocolpos. The incidence of abnormalities first seen postnatally was 0.1% and the most common were isolated cleft palate, polydactyly or syndactyly and ambiguous genitalia or hypospadias; prenatal examination of the genitalia was not a compulsory part of the protocol. A high proportion of fetal abnormalities are detected for the first time during a routine ultrasound examination at 35-37 weeks' gestation. Such diagnosis and subsequent management, including selection of timing and place for delivery and postnatal investigations, could potentially improve postnatal outcome. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Effect of metformin treatment during pregnancy on women with PCOS: a systematic review and meta-analysis.

Some previous studies have found that continued metformin use is beneficial in the management of polycystic ovary syndrome (PCOS) in pregnant women. A systemic review and meta-analysis were needed to more fully assess the effects of metformin on pregnant PCOS patients. The literature was fully searched using MEDLINE, EMBASE, SCOPUS, and COCHRANE for continued metformin use during pregnancy in women with PCOS. A systematic review and meta-analysis were performed to evaluate the comprehensive effects of continued metformin treatment on pregnancy-related outcomes in these women. Eleven eligible studies out of 127 relevant publications were included in meta-analysis. The rates of early pregnancy loss and preterm delivery were found to be significantly decreased in metformin-treated PCOS women. A non-significant difference was found in fetal abnormality and fetal birth weight between the metformin-treated and the non-treated groups. The incidence of gestational diabetes mellitus (GDM) and hypertension/preeclampsia were not significantly different in the two groups, probably because of inconsistent results in the subgroup analysis. Our results showed that continued use during of metformin, during pregnancy in women with PCOS, had no effect on incidence of fetal abnormalities or fetal birth weight. The effects of metformin on GDM and hypertension/preeclampsia should be determined through high-quality randomized controlled trials.

A look at a Hispanic and African American population in an urban prenatal diagnostic center: Referral reasons, amniocentesis acceptance, and abnormalities detected

Purpose: To describe the Hispanic and African-American population referred to our inner city Los Angeles Prenatal Diagnostic Center. To evaluate trends in referral reasons, amniocentesis acceptance, and to assess the number and types of fetal abnormalities found from 1995 to 2001.Methods: A retrospective study using the data from 3085 daily log entries on patients referred for prenatal counseling. The data included race, age, referral reason, amniocentesis decision and results, and fetal abnormalities.Results: The population was 76% Hispanic and 22% African American. Most referrals were for advanced maternal age (42%) and maternal serum screening (28%). The overall amniocentesis acceptance rate was 52%; advanced maternal age amniocentesis acceptance rate was 46%, and maternal serum screen positive amniocentesis acceptance rate was significantly higher at 64%. There was a significant difference between the overall amniocentesis acceptance rate for Hispanics (48%) and African Americans (63%). There was also a significant downward trend in amniocentesis acceptance between 1995 (63%) and 2001 (39%). Amniocentesis acceptance was significantly greater among patients who were < 35 years of age (65%) than those who were older (47%). An incidence of 7% abnormalities was detected by ultrasound and amniocentesis.Conclusions: Acceptance of amniocentesis in the Hispanic and African American population in our prenatal diagnostic center is significantly lower than what has previously been reported in the literature for Caucasians and reported in California statewide prenatal diagnostic center data for non-MS-AFP. There was a significant decline in amniocentesis acceptance from 1995 to 2001. Our incidence of fetal abnormalities was higher than reported in California statewide data.

Male-mediated F 1 effects in mice exposed to 1,3-butadiene

We examined the effects on dominant lethality, the incidence of fetal abnormalities and tumour incidence in surviving offspring of acute and subchronic exposure of male mice by inhalation to the industrial monomer, 1,3-butadiene. In the acute study, CD-1 mice were exposed to atmospheres containing 0 ( n = 25), 1250 ( n = 25) or 6250 ppm ( n = 50) for 6 h, and each male was caged 5 days later for 1 week with two untreated virgin females. One of the females was killed humanely on day 17 of gestation. The other was allowed to deliver and rear her litter and the litters were monitored throughout adulthood. The killed female was examined for the number of live foetuses, the number of post implantation deaths (early and late) and the number and type of any gross malformations. In the subchronic study, males were exposed to 0 ( n = 25), 12.5 ( n = 25) or 1250 ( n = 50) for 6 h per day on 5 days per week for 10 weeks and then mated the next morning. Mating and observation details were as for the acute study. Acute exposure to butadiene resulted in only a small decrease in implantations; after 10 weeks' subchronic exposure with either the high or low concentration, however, a wide variety of statistically significant effects was seen. At 1250 ppm, the number of implantations was reduced, dominant lethal mutations were induced, and the incidences of early and late deaths were increased; some of the live foetuses were malformed. The low dose also increased the frequency of malformations and late deaths but it did not affect the number of early deaths. Skeletal examination of malformed foetuses, randomly selected normal litter mates and controls confirmed the abnormalities seen at necropsy in malformed foetuses. However, karyotypic analysis of foetal liver from malformed foetuses, randomly selected normal litter mates and controls showed no karyotypic abnormalities. The number of gross suspected tumours in the F 1 adults did not appear to reveal an increase over control values. Thus, butadiene is mutagenic in the germ cells of male mice, as shown by the induction of dominant lethality at 1250 ppm, and the frequencies of late deaths and congenital malformations appear to be increased at the subchronic level of 12.5 ppm and skeletal examination of malformed foetuses confirmed the macroscopic abnormalities.

Failure of epoxide formation to influence carbamazepine-induced teratogenesis in a mouse model.

The teratogenic potential of the anticonvulsant drug carbamazepine was determined following chronic oral administration in two inbred mouse strains (SWR/J and LM/Bc). The drug was administered in the animal's diet in concentrations equivalent to 0, 1,000, 1,500, or 2,000 mg/kg body weight, with treatment starting 2 wks prior to mating and continuing throughout gestation. Fetal examination failed to reveal a significant pattern of malformation in either strain at any treatment level. Levels of plasma carbamazepine and its metabolite, carbamazepine-10,11-epoxide, were determined by high pressure liquid chromatography. There was no correlation with either of these compounds and the incidence of fetal abnormality. The inherent teratogenicity of carbamazepine is significantly lower than that of other anticonvulsant drugs that have been similarly tested in an animal model.

The ultrasonic aspects of polyhydramnios.

SUMMARYIn a consecutive series of 250 patients with polyhydramnios, there were 242 patients with chronic and 8 with acute polyhydramnios. The incidence of fetal abnormality in association with chronic polyhydramnios was 18.4% (49 patients); 64% of these abnormalities had features recognisable by ultrasonography but only 28% could have been positively diagnosed by plain radiography. Acute polyhydramnios was associated with uniovular twins, and 2 of the 10 infants were malformed. This study demonstrated that ultrasonography has a greater diagnostic role than radiography in the patient who presents with polyhydramnios.

THE MANAGEMENT OF ABRUPTIO PLACENTAE

Summary The management of abruptio placentae at the Glasgow Royal Maternity Hospital over the five years 1966 to 1970 has been reviewed. There were 379 cases in 29,456 deliveries representing an incidence of 1.3 per cent or 1 in 78 deliveries. The overall perinatal mortality was 38 per cent and there was one maternal death. The perinatal loss related to prematurity and clot size was examined as well as the loss of fetuses which were alive on admission to hospital. Nineteen babies were probably saved by Caesarean section but 13 babies, weighing over 2000 g. and with clinical evidence of fetal distress died in uteroand might have been saved by abdominal delivery. A 4.4 per cent incidence of fetal abnormality was noted. The role of fetal monitoring and Caesarean section are briefly discussed.

SAFETY OF DIAGNOSTIC ULTRASOUND IN OBSTETRICS

Abstract Ultrasound examinations were carried out on 1114 apparently normal pregnant women cared for in three different centres, at various stages of pregnancy and with differing ultrasonic frequencies throughout. The incidence of fetal abnormality in the group was 2·7%. Neither the time in gestation of the first examination nor the number of examinations seemed to increase the risk of fetal abnormality.

SAFETY OF DIAGNOSTIC ULTRASOUND IN OBSTETRICS

Ultrasound examinations were carried out on 1114 apparently normal pregnant women cared for in three different centres, at various stages of pregnancy and with differing ultrasonic frequencies throughout. The incidence of fetal abnormality in the group was 2·7%. Neither the time in gestation of the first examination nor the number of examinations seemed to increase the risk of fetal abnormality.

Incidence of teratogeny induced by vitamin E deficiency in the rat.

SummaryHoltzman and Sherman strain female albino rats were raised on tocopherol-free or tocopherol-supplemented diets for 3 months, then bred to normal males. On the 9th to 11th day of gestation most of the depleted females received a tocopherol supplement by stomach tube. All animals were sacrificed on the 21st day of gestation and the uteri and fetuses examined for resorptions and congenital malformations. Of the 92 developed fetuses produced by those rats receiving the delayed supplements, only 4—or less than 5% of the total—showed any gross abnormalities. This finding contrasts sharply with earlier reports of others, wherein almost half of the surviving fetuses were found to be defective. The reasons for these differences are not clear. The reproductive performance of rats raised and bred on a diet containing 2 mg of tocopherol per 100 of diet was normal, but when the tocopherol level was lowered to 1 mg or 0.5 mg the incidence of fetal abnormalities became 4 and 5%, respectively, of the developed you...

The Use of Progesterone in Combating Habitual Abortion

Summary 1. In 40 cases of repeated spontaneous abortion treated by progesterone and thyroid extract, 36 living children were born. 2. Pure progesterone seems to be more effective than the extract of the corpus luteum. 3. The fact that a pregnancy has been successfully completed does not obviate the necessity for treatment in subsequent pregnancies. 4. The incidence of fetal abnormality is high among women who bear children after having previously aborted. 5. Endocrinologic investigation of women who bear defective children may be the means of discovering the cause and providing a method of eliminating this complication of pregnancy.